Individual
DR. SUSAN MARY MACKINNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
328 AMBOY AVE, METUCHEN, NJ 08840-2456
(732) 906-6371
(732) 846-8712
Mailing address
264 GRANT AVE, HIGHLAND PARK, NJ 08904-1810
(732) 628-0919
(732) 846-8712
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35S100281800
NJ
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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